Evaluation of preoperative elevation of serum c-reactive protein as an indicator for prognosis of colorectal cancer

  Abstract   Background : Cancer has not been elucidated in colerectal site. C-reactive protein   (CRP) is a product synthesized in hepatocytes and has been reported to be up-regulated   by such proinflammatory cytokines as interleukin-1 (IL-1), interleukin-6 (IL-6),   and tumor necrosis factor (TNF). The significance of a preoperative serum elevation   was evaluated using CRP as a predictive indicator for the malignant potential and   prognosis.   Methods: Forty consecutive patient with colorectal cancer whose local lesions   were resected in our department, plus forty healthy volunteers, were selected. Any   patient with inflammatory diseases such as infection or collagen disease was excluded   from the current study. The preoperative serum CRP level and the control group   were measured. The relationships between the serum elevation of CRP and both the   clinicopathologic factors and prognosis of the patients was investigated.   Results: The rate of patients with elevated serum CRP level was significantly   higher in the colorectal cancer patients in comparison to the control group (55% versus   2.5%). Furthermores the incidence of liver metastasis, peritoneal carcinomatosis,   histopathologic lymph nodes metastasis, and tumor invasion in colorectal cancer patients   with a preoperatively elevated serum CRP level were significantly more frequent   than in those with a negative serum CRP level. The survival rates of the colorectal   cancer patients without a preoperative elevation of the serum CRP proved to   be significantly more favorable than that of the colorectal cancer patients with such   an elevation (94.4% versus 59.1% P<0.001).   Conclusion: Apreoperative serum elevation of CRP was thus found to be an indicator   of the malignant potential of the tumor as well as prognostic factor for patients   with colorectal cancer.